[Overlapping ventriculoplasty for ischemic cardiomyopathy]

We have previously reported overlapping cardiac volume reduction operation (OLCVR) for dilated cardiomyopathy. Because of the acceptable clinical outcome and especially the excellent ellipsoidal shape of the left ventricle (LV) after surgery, we extended this indication for ischemic cardiomyopathy (ICM) with dilated LV. In such cases we combined OLCVR with mitral annuloplasty and papillary muscles approximation (PMA), called integrated overlapping ventriculoplasty (IOLVP). From March 2003 to July 2004, we performed IOLVP with coronary artery bypass grafting (CABG) for 8 patients who were diagnosed ICM. There is no operative mortality. Pre- and postoperative hemodynamics data are follows: LV ejection fraction (LVEF) improved from 22.4 +/- 11.9 to 33.4 +/- 10.5%, LV end-diastolic volume index (LVEDVI) decreased from 155.5 +/- 26.5 to 93.7 +/- 13.5 ml/m2 and LV end-diastolic diameter (LVDd) diminished from 66.0 +/- 8.9 to 60.5 +/- 8.4mm. Mitral regurgitation changed from 2.6 +/- 0.8 to 0.1 +/- 0.2 degree. New York Heart Association (NYHA) functional class improved from 3.3 +/- 0.5 to 1.3 +/- 0.5. LV shape became ellipsoidal without akinesis lesion. IOLVP is considered as a good option for ICM with dilated left ventricle.

Morphological changes in hepatic vascular endothelium after carbon dioxide pneumoperitoneum in a murine model

BACKGROUND

Liver metastasis is an important prognostic factor in advanced colorectal cancer. Several studies have demonstrated that carbon dioxide (CO2) pneumoperitonem enhances liver metastasis in an animal model. In the present study, we used scanning electron microscopy (SEM) to investigate morphological changes in hepatic vascular endothelium after CO2 pneumoperitoneum in a murine model.

METHODS

Thirty-three male BALB/c mice were randomized to undergo pneumoperitoneum (CO2, air, or helium), open laparotomy, and anesthesia alone. After each procedure, the animals' livers were excised at days 0, 1, and 3 and examined by SEM.

RESULTS

In the CO2 pneumoperitoneum group, we observed rough surface and derangement of the hepatic vascular endothelial cells and intercellular clefts on day 1. In the other groups, no major morphologic changes were observed at any time.

CONCLUSIONS

Hepatic vascular endothelium changes after CO2 pneumoperitoneum. Such characteristic changes may play an important role in establishing liver metastasis after CO2 pneumoperitoneum.

Effect of 5-Campestenone (24-methylcholest-5-en-3-one) on Zucker diabetic fatty rats as a type 2 diabetes mellitus model

We examined the therapeutic effects of dietary exposure to 5-campestenone (24-methylcholest-5-en-3-one), an enone derivative of campesterol, in Zucker diabetic fatty (ZDF) rats, an animal model of type 2 diabetes mellitus. Dietary 0.6 % exposure to 5-campestenone caused marked reduction in hemoglobin A1c (HbA1c), plasma total cholesterol, triglycerides and non esterified fatty acid (NEFA). In particular, plasma triglyceride levels were reduced in the 0.6 % 5-campestenone-fed group to about 25 % of that in the control group. In the oral glucose tolerance test (OGTT) at three and seven weeks after the beginning of treatment, 5-campestenone limited the rise of blood glucose levels by oral administration of glucose dose-dependently. Amounts of adipose tissue in the retroperitoneum and periepididymal area as well as abdominal subcutaneous fat were significantly decreased in animals fed 0.6 % 5-campestenone. The blood leptin concentration on the final day of feeding was significantly in animals administered 5-campestenone. No obvious anomaly due to consumption of 5-campestenone was detected in necropsy or clinical observations.

Rapid adsorption pretreatment with submicrometre powdered activated carbon particles before microfiltration

Manufacturer-supplied powdered activated carbon (PAC) was ground to produce submicrometre particles (0.8 and 0.6 m median diameter) for use as an adsorbent before microfiltration (MF) for drinking water treatment. Batch tests revealed that the microground PAC adsorbed natural organic matter (NOM) much more rapidly and had a higher adsorptive capacity than ordinary PAC. The water samples pretreated with the submicrometre PAC were subjected to MF, and the results of experiments with different PAC contact times revealed that a 1 min retention time was sufficient for adsorptive removal of NOM. The use of submicrometre PAC permitted not only shorter PAC contact times but also a 75% reduction in dose.

Effect of uncertainties in agricultural working schedules and Monte-Carlo evaluation of the model input in basin-scale runoff model analysis of herbicides

In the prediction of time-series concentrations of herbicides in river water with diffuse-pollution hydrological models, farming schedules (the dates of herbicide application and drainage of irrigation water from rice paddies) greatly affect the runoff behavior of the herbicides. For large catchments, obtaining precise data on farming schedules is impractical, and so the model input inevitably includes substantial uncertainty. This paper evaluates the effectiveness of using the Monte-Carlo method to generate sets of estimated farming schedules to use as input to a GIS-based basin-scale runoff model to predict the concentrations of paddy-farming herbicides in river water. The effects of using the Monte-Carlo method to compensate for uncertainty in the evaluated parameters for herbicide decomposition and sorption were also evaluated.

[Ischemic cardiomyopathy treated with overlapping ventriculoplasty]

A 58-year-old man was admitted due to congestive heart failure. Left ventriculography showed end-diastolic volume index (EDVI) of 172 ml/m2 and ejection fraction (EF) of 16%. Coronary angiography showed severe double vessel disease (the left anterior descending artery and the right coronary artery). Echocardiography showed dilated heart [left ventricular end-diastolic diameter (LVDd) of 74 mm] and severe mitral regurgitation due to tethering of the leaflets. The patient underwent our original left ventricular volume reduction operation, termed overlapping ventriculoplasty (OLVP) combined with mitral annuloplasty, papillary muscles plication (PMP) and coronary artery bypass grafting (CABG). The postoperative course was excellent. Postoperatively, the EDVI decreased to 96 ml/m2, the LVDd diminished to 67 mm, and the EF improved to 34%. This case implies the role of left ventricular remodeling procedure of OLVP and PMP in the ischemic cardiomyopathy with ischemic mitral regurgitation.

Classification of portal vein anatomy for partial liver transplantation

The anatomy of the portal vein is usually classified as 3 to 5 patterns and simple compared with the anatomy of the hepatic artery. The variety of portal vein anatomy was examined in 287 living donors for liver transplantation. More than 90% of donors showed a normal bifurcation type; 6% showed the trifurcation type. Only 3% displayed a separate origin of the right paramedian and the right lateral branches. There was no anomalous pattern that had not been reported previously. In our series, we conclude that it is rare for 2 or more stumps of portal vein to appear in partial liver transplantation. The frequency is much less if the left liver or the right lateral liver graft is used for adult-to-adult living donor liver transplantation.

Metallic ferromagnet with square-lattice CoO2 sheets

A single-crystalline film of Sr2CoO4 with square-lattice CoO2 sheets (K2NiF4-type structure) was synthesized, and its electronic properties were characterized. The compound exhibited both ferromagnetic and metallic behaviors, with a fairly high Curie temperature T(C) of approximately 250 K, in contrast to the superconductivity recently found in a triangular-lattice CoO2-sheet compound. The film's large magnetoresistance with current perpendicular to the CoO2 plane showed field-hysteretic behavior analogous to tunneling magnetoresistance. The electronic structure of Sr2CoO4 was also investigated to characterize the quasi-two-dimensional ferromagnetic metal state in terms of optical spectroscopy and first-principles calculation.

The association of lumbar spondylolisthesis with collagen IX tryptophan alleles

Two collagen type IX gene polymorphisms that introduce a tryptophan residue into the protein's triple-helical domain have been linked to an increased risk of lumbar disc disease. To determine whether a particular subset of symptomatic lumbar disease is specifically associated with these polymorphisms, we performed a prospective case-control study of 107 patients who underwent surgery of the lumbar spine. Patients were assigned to one of five clinical categories (fracture, disc degeneration, disc herniation, spinal stenosis without spondylolisthesis and spinal stenosis with spondylolisthesis) based on history, imaging results, and findings during surgery. Of the 11 tryptophan-positive patients, eight had spinal stenosis with spondylolisthesis and three had disc herniation. The presence of the tryptophan allele was significantly associated with African-American or Asian designation for race (odds ratio 4.61, 95% CI 0.63 to 25.35) and with the diagnosis of spinal stenosis with spondylolisthesis (odds ratio 6.81, 95% CI 1.47 to 41.95). Our findings indicate that tryptophan polymorphisms predispose carriers to the development of symptomatic spinal stenosis associated with spondylolisthesis which requires surgery.

Safety of hepatectomy for living donors as evaluated using asialoscintigraphy

In the living donor operation, accurate estimation of hepatic functional reserve is essential. Technetium-99m-galactosyl-human serum albumin (GSA) is a liver scintigraphy agent that binds to asialoglycoprotein receptors. We evaluated the preoperative assessment of the safety of an elective hepatectomy using GSA liver scintigraphy in 152 patients. GSA scintigraphy was performed after intravenous injection of GSA. The maximal removal rate of GSA (GSA-Rmax) was calculated using a radiopharmacokinetic model. We determined the areas for resection preoperatively depending on the operative procedures and calculated the local GSA-Rmax in the predicted residual liver (GSA-RL). A significant correlation was obtained between the GSA-Rmax and the 15-minute retention rate of indocyanine green. With sub- and monosegmentectomy, 2 patients had postoperative hepatic failure; in those 2 patients, the GSA-RL was 0.127 and 0.133, respectively, but these patients recovered well. Among those having di- and tri-segmentectomy, 5 patients experienced postoperative hepatic failure, in all subjects the GSA-RL was <0.15. Two patients died of postoperative liver failure 1 to 2 months after the operation. We concluded that GSA-RL is useful to select the procedure for hepatectomy in living donors and that GSA-RL should be >0.15 (mg/min/50 kg body weight) to avoid postoperative hepatic failure.

Functional hepatic regeneration following hepatectomy using galactosyl-human serum albumin liver scintigraphy

In extended hepatectomy and liver transplantation, accurate estimation of functional hepatic regeneration is more important than volumetric regeneration. We investigated the usefulness of measuring the functional hepatic volume by 99m-technetium galactosyl-human serum albumin scintigraphy (GSA). Extended hepatectomy was performed in 32 patients. These patients were divided into subgroups with or without chronic hepatitis or cirrhosis. Functional hepatic volume GSA scintigraphy (GSA-LV) and determination of hepatic volume by CT (CT-LV) measurements were performed preoperatively, at 2 and 4 weeks and at 3 and 6 months after surgery. The preoperative GSA-LV values were significantly correlated with the hepatocyte volume and the 15-minute retention rate of indocyanine green (ICGR15). Similarly, the hepatocyte volume correlated well with the CT-LV and ICGR15. However, the CT-LV correlated only with the ICGR15. Recovery of the GSA-LV was delayed, and about 90% of the volumetric and functional regeneration was observed within 6 months after the hepatectomy. In contrast, the CT-LV in patients with normal liver remnants returned to approximately 90% of the initial volume within 1 month after the hepatectomy, whereas patients with injured livers regeneration showed gradual recovery to approximately 80% of the preoperative value by 6 months after hepatectomy. We conclude that measurement of functional hepatic volume using the GSA-LV is useful to evaluate hepatic function based on hepatocyte volume.

[Aberrant subclavian artery]

Aberrant subclavian artery (ASA) is the most frequently encountered congenital anomaly of aortic arch. The ASA aneurysms are rare but potentially lethal disease, it has been recognized that the presence of an aneurysm of an ASA itself is an indication for surgery. We experienced 4 cases with ASA during the past 23 years. All cases were male. Their ages ranged from 51 to 73 years old. Three patients had a right-sided aortic arch. Among the 4 patients, only 1 underwent total arch replacement, but the other 3 patients could be followed conservatively for 1, 7 and 23 years, respectively. We reviewed the problem of the diagnosis and treatment of the ASA including surgical indication.

Impact of biochemical failure on long-term clinical outcome after radical prostatectomy for prostate cancer in Japan

Detailed information is needed to understand the impact of biochemical failure (bF) on long-term outcome after definitive therapy for prostate cancer. In all, 223 consecutive men treated with radical retropubic prostatectomy were followed and long-term clinical outcome was investigated. Pathological examination revealed more locally advanced tumors in this study compared with the typical cohorts seen in the Western series. The Cox proportional hazards model indicates pretreatment prostate-specific antigen levels and risk group stratification to be a significant predictors for bF (P<0.05), but not for overall survival. Seminal vesicle involvement was a significant predictor of systemic progression, cancer death and overall survival (P<0.05). Positive surgical margin and bF were also found to be independent predictors of overall survival (P<0.05). In contrast to reports from Western countries, this study found a significant correlation between bF after radical prostatectomy and overall survival. This may reflect years-later detection of prostate cancer in Japan compared with Western series. Biochemical failure may ultimately be translated into decreased overall survival after sufficient follow-up.

A 3-y prospective study of health-related and disease-specific quality of life in patients with nonmetastatic prostate cancer treated with radical prostatectomy or external beam radiotherapy

We assessed the longitudinal alteration of the quality of life (QOL) of patients with localized prostate cancer after radical prostatectomy or hormonoradiotherapy during 3-y follow-up. In addition, we examined the impact on QOL of initiation of second treatment after failure of primary treatment. In all, 135 patients with localized prostate cancer who underwent radical retropubic prostatectomy (RP) (N=84) or external beam radiotherapy with neoadjuvant hormone (XRT) (N=51) at our institute and who had a minimum follow-up of 3 y were included in this study. Data were collected prospectively, at baseline, at 3 months after treatment, at 1 y, and annually thereafter. QOL, generic and disease-targeted was evaluated using the European Organization for Research and Treatment of Cancer Prostate Cancer QOL Questionnaire, the Sapporo Medical University Sexual Function Questionnaire, the International Prostate Symptom Index Quality of Life Score and similar questions regarding bowel function. Repeated-measures ANOVA revealed significantly different patterns of alteration in the domains of QOL, with the exception of several domains, between the RP and XRT groups. Rapid decline of sexual function and increase in sexual bothersomeness were followed by slight amelioration throughout follow-up in the RP group, and did not change thereafter in the XRT group. Overall satisfaction with urinary condition significantly improved after treatment and that with bowel condition was stable during follow-up in both of the groups. Failure of primary treatment and initiation of salvage treatment had no impact on QOL. This prospective study revealed longitudinal alteration of QOL status of patients undergoing treatment for localized prostate cancer, but did not yield any conclusions regarding effect of treatment failure and second treatment on QOL due to small sample size. It should be noted that different instruments for assessment of QOL can generate different outcomes.

[Aortic root replacement with free-style stentless valve for aorto-left and right ventricular communication due to infective endocarditis; report of a case]

Aortic root abscess remains a major determinant of both early and late results of surgical treatment of endocarditis. This complication rarely progresses to intracardiac shunt followed by cardiac failure. We report a surgical case of a 40-year-old man, who had been diagnosed as prosthetic valve endocarditis with aortic root abscess ruptured into left and right ventricle creating aorto-left and right ventricular communication. Because of complete debridment of infective and/or dead tissue, aortic root replacement was required. We used free-style stentless valve, xenograft, since homograft was not available at the time of operation. We believe that this prosthesis has easier handling and is more resistant to infection, therefore, it might be an option for infective endocarditis with aortic root abscess.

Irreversible and reversible adhesion between virus particles and hydrolyzing-precipitating aluminium: a function of coagulation

The infectivity of viruses (Qbeta, MS2, T4, and P1) after dosing virus-contaminated water with 4 types of aluminium coagulant was investigated. The concentrations of infectious viruses were determined after dissolving aluminium hydroxide flocs in alkaline solution. The concentration of infectious viruses did not recover to the initial value after a short floc-dissolution time (5 s). Although the infectious virus concentration increased as the floc-dissolution time was extended to 5 h, it did not recover fully. Irreversible adhesion between virus particles and aluminium coagulant is responsible for the insufficient recovery. We interpret this phenomenon as a virucidal activity of the aluminium coagulant. All tested aluminium coagulants (PACl, alum, and reagent grade aluminium chloride and aluminium sulfate) inactivated all types of viruses tested. PACl had the highest virucidal activity. The virucidal activity of aluminium coagulants was lower in river water, presumably owing to the presence of natural organic matter.

Characterization of microparticles in raw, treated, and distributed waters by means of elemental and particle size analyses

The elemental composition and particle size distribution of suspended particles in raw water, treated water, and distributed water were determined to understand the behavior of particles during the water treatment-distribution process. The weight of suspended particles collected on a 0.6-microm filter was 1.1 times (raw water), 1.4 times (treated water), and 1.5 times (distributed water) that collected on a 2.7-microm filter, suggesting that smaller particles may remain after conventional water treatment. Organic suspended particles were removed less efficiently than inorganic suspended particles. After sand filtration, the Al content in the fixed suspended solids (FSS) markedly increased, indicating that either a small percentage of aluminium floc passed through during sand filtration or dissolved aluminum precipitated after sand filtration. The Mn and Fe concentrations increased after chlorination. The percentages of carbon and nitrogen in the volatile suspended solids (VSS) were roughly the same in the raw, treated, and distributed waters. The carbon/nitrogen/phosphate/VSS ratios indicated that the VSS of the suspended particles consisted of organic matter originating from microorganisms. The major constituents of the FSS in the treated and distributed waters were compounds of Fe, Al, Ca, Mg, and Mn, but these compounds accounted for only 16% or less of the FSS in raw water, indicating the existence of Si compounds. In distribution pipes, the total suspended solids concentration, especially the FSS concentration, was higher than that of water just after treatment. The Fe concentration in distributed water increased, probably due to oxidation and rusting of iron pipes.

[Surgical treatment to an old patient with right coronary artery aneurysm; report of a case]

The patient was 75-year-old woman. The patient was referred to our hospital for operation due to a developing right coronary artery aneurysm. The coronary artery angiography showed that the aneurysm was 3 cm in diameter which had not existed two years previously, and with a 75% distal stenosis. The operation was made during cardiac arrest. A sapheous vein graft was used to bypass to the distal artery first. Then the aneurysm was resected, and both proximal and distal arteries were ligated. The pacemaker was implanted on the third postoperative day for sick sinus syndrome, the patient got a better recovery. Surgical treatment should be recommended to coronary artery aneurysm, and sapheous vein was a good selection for bypass graft when the diameter of native artery was relatively large.

Prediction of functional recovery after coronary bypass surgery using quantitative gated myocardial perfusion SPECT

Previous studies have demonstrated that myocardial perfusion imaging using 99mTc-tetrofosmin at rest allows viability assessment similar to that obtained with 201Tl imaging and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET). The simultaneous assessment of perfusion and regional function is now available by quantitative gated myocardial perfusion single-photon emission computed tomography (SPECT). This study was designed to evaluate the utility of quantitative values of wall motion and wall thickening, calculated by quantitative gated myocardial perfusion SPECT, for the prediction of functional recovery after coronary bypass grafting (CABG). Fifty-six patients with coronary artery disease scheduled for CABG were included prospectively. All patients underwent 99mTc-tetrofosmin gated SPECT imaging at rest preoperatively and 3 months after CABG. The myocardium was divided into nine segments and the average quantitative values of regional perfusion (percentage uptake) (%), wall motion (mm) and wall thickening (%) were determined automatically using quantitative gated SPECT (QGS) software. The wall motion score was defined visually using a four-point scale (0, normal; 3, akinesis), and segments with severe asynergy (score of 2 or 3) with patent grafts were assessed. Of 77 segments with severe asynergy, 56 segments showed improved wall motion and 21 segments did not improve after CABG. The area under the receiver operating characteristic curve of wall thickening for the prediction of functional recovery was significantly higher (0.92) than that of the percentage uptake (0.77, P<0.017) or wall motion (0.60, P<0.0001). When each analysis used the optimal threshold, the wall thickening analysis (>or=10%) had a sensitivity of 95% and a specificity of 81%. These values tended to be higher than those of the percentage uptake (sensitivity, 86%; specificity, 67%). The wall motion analysis (>or=1.5 mm) had a significantly lower sensitivity of 75% and specificity of 43% than the wall thickening analysis (P=0.0038 and P=0.011, respectively). The results indicate that wall thickening, calculated by QGS software, may be more useful than regional perfusion or wall motion analysis for the prediction of functional recovery after CABG. The areas of asynergy with relatively preserved wall thickening may have the potential for improved function despite severely decreased perfusion.

Random potential effect near the bicritical region in perovskite manganites as revealed by comparison with the ordered perovskite analogs

The orbital-charge-spin ordering phase diagram for half-doped perovskites Ln(1/2)Ba(1/2)MnO3 (Ln = rare earth) with ordered Ln/Ba cations has been investigated comparatively with that of the Ln/Ba solid-solution analogs. A large modification of the phase diagram is observed upon the A-site disordering near the original bicritical point between the charge-orbital ordering and ferromagnetic metallic phases. The random potential by quenched disorder inherent in the A-site solid solution is found to suppress the respective long-range orders and gives rise to the colossal magnetoresistive state.

Clinicopathologic evaluation after resection for ductal adenocarcinoma of the pancreas: a retrospective, single-institution experience

INTRODUCTION

Between April 1992 and December 2000, 167 patients with pancreatic carcinoma were evaluated and treated in our department. One hundred eight patients (64.7%) with pancreatic carcinoma underwent pancreatectomy. Of these patients, 94 had histologically proven ductal adenocarcinoma. The overall postoperative mortality rate was 3.2% (3 patients), and the morbidity rate was 35.1% (33 patients). The estimated 1-, 2-, 3-, and 5-year survival rates were 43.6%, 28.7%, 21.8%, and 12.9%, respectively. There were only six long-term survivors who survived >5 years after surgery. METHODOLOGY AND AIMS: Institutional experience with 94 consecutive patients with ductal adenocarcinoma who underwent pancreatectomy was reviewed to clarify the influence of 29 prognostic factors (5 host, 17 tumor, and 7 treatment factors). Special reference was made to determine whether these significant factors have an effect on long-term survival. Univariate and multivariate models were used to analyze the effect of prognostic factors on survival.

RESULTS

Univariate analysis indicated that blood loss, operative time, postoperative complications, histopathologic lymphatic and venous permeation, lymph node metastasis, conclusive stage, conclusive curability, resection margins, serosal invasion, size of tumor, retroperitoneal invasion, major arterial invasion, and mode of histologic infiltration were associated with significantly longer survival (p < 0.05). By Cox proportional hazards survival analysis, the most powerful predictors of outcome were venous permeation, lymph node metastasis, tumor diameter, and conclusive curability. The longest-term survivor had the most advanced stage (stage IV(b)) of disease and curability C. No long-term survivors had all of the good prognostic factors (according to multivariate analysis).

CONCLUSIONS

The prognosis after surgical resection of pancreatic carcinoma mostly depends on tumor factors. In this study, it was difficult to identify the determinants of long-term survival in patients with resectable tumors.

Prevention of pleural effusion following hepatectomy using argon beam coagulation

BACKGROUND

Postoperative pleural effusion occurs frequently after hepatectomy. The value of the argon beam coagulator (ABC) for the prevention of pleural effusion after hepatectomy in patients with hepatocellular carcinoma was studied.

METHODS

Sixty patients were divided randomly into two groups: an ABC group (n = 28), in which the cut surface of the hepatic ligaments and bare area of the retroperitoneum were cauterized using an ABC, and a control group (n = 32) in which the ABC was not applied. Patient characteristics, preoperative and postoperative liver function, and postoperative pleural effusion were compared between the two groups.

RESULTS

There were no significant differences between the two groups with respect to histological findings, clinical stage, type of resection, operative data, and preoperative and postoperative laboratory data. One of 28 patients in the ABC group and nine of 32 patients in the control group had pleural effusion. The incidence was significantly lower in the ABC group than in the control group (P = 0.01). Pleurocentesis was needed in two of the ten patients and thoracic drainage in four patients.

CONCLUSION

Application of an ABC to the cut surface of the hepatic ligaments and bare area of retroperitoneum after liver mobilization may prevent postoperative pleural effusion.

Tartrate resistant acid phosphatase (TRAP) positive cells in rheumatoid synovium may induce the destruction of articular cartilage

OBJECTIVE

To examine the role of tartrate resistant acid phosphatase (TRAP) positive mononuclear and multinucleated cells in the destruction of articular cartilage in patients with rheumatoid arthritis (RA).

METHODS

The presence of TRAP positive cells in the synovial tissue of patients with RA was examined by enzyme histochemistry and immunohistochemistry. Expression of mRNAs for matrix metalloproteinases (MMPs) was assessed by the reverse transcriptase-polymerase chain reaction (RT-PCR) and northern blot analysis. Production of MMPs by mononuclear and multinucleated TRAP positive cells was examined by immunocytochemistry, enzyme linked immunosorbent assay (ELISA) of conditioned medium, and immunohistochemistry of human RA synovial tissue. In addition, a cartilage degradation assay was performed by incubation of (35)S prelabelled cartilage discs with TRAP positive cells.

RESULTS

TRAP positive mononuclear cells and multinucleated cells were found in proliferating synovial tissue adjacent to the bone-cartilage interface in patients with RA. Expression of MMP-2 (gelatinase A), MMP-9 (gelatinase B), MMP-12 (macrophage metalloelastase), and MMP-14 (MT1-MMP) mRNA was detected in TRAP positive mononuclear and multinucleated cells by both RT-PCR and northern blot analysis. Immunocytochemistry for these MMPs showed that MMP-2 and MMP-9 were produced by both TRAP positive mononuclear and multinucleated cells, whereas MMP-12 and MMP-14 were produced by TRAP positive multinucleated cells. MMP-2 and MMP-9 were detected in the conditioned medium of TRAP positive mononuclear cells. TRAP positive mononuclear cells also induced the release of (35)S from prelabelled cartilage discs.

CONCLUSION

This study suggests that TRAP positive mononuclear and multinucleated cells located in the synovium at the cartilage-synovial interface produce MMP-2 and MMP-9, and may have an important role in articular cartilage destruction in patients with RA.

Mucoadhesive properties of carbopol or chitosan-coated liposomes and their effectiveness in the oral administration of calcitonin to rats

Mucoadhesive liposomes were prepared by coating multilamellar liposomes with Carbopol (CP) in a similar manner to that used in the preparation of chitosan-coated liposomes (CS-Lip) previously reported [Takeuchi et al., Chem. Pharm. Bull. 42 (1994) 1954-1956; Pharm. Res. 13 (1996) 896-901]. The positively charged liposomes containing dipalmitoylphosphatidylcholine (DPPC) and stearylamine at an optimum formulation ratio (40:1) could be coated with CP without aggregation of the liposomal particles during the coating process. The mucoadhesive properties of both the resultant polymer-coated liposomes (CP-Lip and CS-Lip) and the positively or negatively charged noncoated liposomes (Non-Lip) were evaluated using the rat intestine. The order was CS-Lip> or = CP-Lip>positively charged Non-Lip>negatively charged Non-Lip. The adhesive property of CP-Lip decreased on increasing pH of the dispersing medium from pH 5.0 to 7.4, probably owing to the electric repulsion between CP-Lip and the mucus layer. The effectiveness of the liposomal formulations in oral administration of calcitonin was evaluated by measuring the change in the blood calcium concentration of rats. Administration of CP-Lip and CS-Lip containing calcitonin showed an enhanced and prolonged reduction in blood calcium concentration. The overall pharmacological effect of CP- and CS-Lips evaluated by means of the area under the plasma calcium concentration curve was 2.4 and 2.8 times higher than that of negatively and positively charged Non-Lips, respectively.

Successful conservative therapy for portal vein thrombosis after living donor liver transplantation

Portal vein thrombosis remains a significant cause of graft loss in liver transplantation. A case with thrombosis at the anastomotic site is described. Close follow-up with ultrasound enabled us to treat the patient promptly and successfully with anticoagulants.

Thrombectomy of portal vein thrombosis in living donor liver transplantation

We describe a case of living donor liver transplantation where an intrahepatic portal vein embolism was detected by intraoperative ultrasonography after the completion of portal and arterial anastomoses. The recipient portal vein trunk was clamped and the ligature of the graft's right portal branch was released, thus maintaining the sole arterial supply. Backward flushing of the portal system was achieved, which removed the clot through the reopened right portal branch without the need for thrombectomy by Fogarty balloon catheter.

Software techniques for EELS to realize about 0.3 eV energy resolution using 300 kV FEG-TEM

In this short communication we describe some software techniques for electron energy-loss spectrum measurement. We prepared DigitalMicrograph (Gatan) scripts for multiple spectrum acquisitions, quasi-simultaneous acquisition of low-loss and core-loss spectra, energy drift correction, and other operations. Narrow zero-loss spread of 0.27 eV is demonstrated using a 300 kV field-emission transmission electron microscope (TEM) (Hitachi, HF-3000) and a post-column energy filter (Gatan, GIF2002). The core-loss spectrum is acquired with an energy resolution of 0.36 eV with high reproducibility. The present software techniques effectively achieve the intrinsic energy resolution of electron sources. Sample scripts are provided in the Appendix.

Ferromagnetic domain structures and nanoclusters in Nd(1/2)Sr(1/2)MnO3

Magnetic domain structures of Nd(1/2)Sr(1/2)MnO3 were investigated by means of low-temperature Lorentz electron microscopy. On cooling, magnetic domain walls started to appear at 250 K, and they were oriented straight along the [100] and [110] directions. With a further decrease in temperature, the volume of each magnetic domain increased with discontinuous domain-wall jumps. A characteristic granular image was observed at around 140 K, near the charge-ordering transition temperature. We consider that this originated from ferromagnetic nanoclusters that appeared in the antiferromagnetic matrix.

Collagen polymorphisms of the intervertebral disc

The mechanical function and the collagen phenotype of the disc are complex, each a hybrid of elements of ligament and cartilage. In detail, the collagen properties are unique. Collagens I and II provide the bulk of the tissue fabric interwoven in opposing radial concentration gradients. From analysis of isolated cross-linked peptides, some degree of commingling of these major fibrillar collagens occurs down to the molecular level. Collagens V, VI, IX, XI, XII and XIV all contribute to the matrix. Collagen IX is the short molecular form that lacks a non-collagenous (NC)4 domain, not the long form found in most hyaline cartilages. Protein sequence and reverse transcriptase-PCR analysis confirmed this was the result of expression from the alternative transcription start site, not proteolysis of the long form. In view of recent reports that common single nucleotide polymorphisms in COL9A2 and COL9A3 are linked to chronic sciatica associated with disc pathology, the specific interactions and role of collagen IX in disc tissue are important to define.

[An evaluation of the potential ischemia of the forearm after harvesting of radial artery by near infrared spectroscopy]

We evaluated the potential ischemia of the forearm after harvesting of radial artery (RA) for coronary artery bypass grafting (CABG) by near infrared spectroscopy (NIRS). The subjects consist of two groups; patients group (group P) including 18 patients who received CABG with RA and control group (group C) including 9 healthy volunteers. Group P was divided into two groups; early post operative group (group E, n = 11) and mid-term post operative group (group M, n = 7). NIRS was used to measure the recovery time (RT) in the muscles of the forearm during occlusion test. There was a significant prolongation of the RT in group P than group C. There was no significant difference of the RT between group E and group M. In conclusion, harvesting of RA may cause ischemia of the forearm and it may continue for a long time.

Early closure of growth plate causes poor growth of long bones in collagen-induced arthritis rats

Abnormalities of the epiphyseal growth plate that occur in collagen-induced arthritis (CIA) were studied. CIA was induced in 6-week-old Lewis rats by immunization with type II collagen. Radiographic examination revealed the early closure of the epiphyseal growth plate with growth retardation of the femur and tibia. Histological evaluation confirmed the early closure of the epiphyseal growth plate accompanied by decreased intensity of safranin-O staining indicating decreased amounts of proteoglycans in the extracellular matrix (ECM) of the cartilage. Immunohistochemical methods showed that the number of chondrocytes expressing matrix metalloproteinase (MMP)-3 and/or vascular endothelial growth factor (VEGF) increased in the growth plates of CIA rats. This study confirmed that disturbances of long bone growth with early closure of the epiphyseal growth plates occur in CIA. There appeared to be overexpression of MMP-3, which may be involved with proteoglycan degradation. Additionally, VEGF, which is associated with cartilage ossification and angiogenesis, might also play a role in this event. Further clarification of the mechanism of the growth disturbance in CIA may yield clinical benefits, especially in prevention of the premature closure of growth plate that is seen in juvenile rheumatoid arthritis and other diseases.

Charge/orbital ordering structure of Pr(1-x)Ca(x)MnO(3)(x = 3/8) examined by low-temperature transmission electron microscopy

The structural phase transition of Pr(1-x)Ca(x)MnO(3)(x = 3/8) was investigated by means of low-temperature transmission electron microscopy. Superlattice reflection spots with a modulation wave vector q(1) = (0,1/2,0) appeared below 230 K, indicating formation of the d(3x(2-r(2))/d(3y(2)-r(2)) type of charge/orbital ordering. Below 150 K, a new series of superlattice reflection spots with a modulation wave vector q(2) = (1/4,1/4,1/2) appeared, suggesting an additional ordering of excess 1/8 Mn(3+), necessary due to the deviation of x from 1/2, with the occupation of the d(3z(2-r(2)) type of e(g) orbital.

The effect of flow pattern on kinetic characteristic of the biomass fixed inside porous medium

The characteristics of the biomass fixed inside porous medium (sponge cube) have been investigated to see whether it can be recognized as biofilm. The acrylic cube is used as control medium. Three types of flow pattern of bulk water are used in the test to examine is effect on substrate transportation. From the kinetic test, it is found that the biomass fixed inside the sponge cube has biofilm characteristics. For conditions where the diffusion phenomenon is dominant, two layers whose yield constant are different to each other are confirmed from stoichiometric study. When the sponge cube is in the counter flow, it was found that the whole biomass fixed inside the medium works at the same time. It is considered that a certain amount of water is flowing through the medium when the sponge cube is exposed to counter flow. When the water is totally flowing through the sponge cube during the kinetic test by using type-3 reactor, a Michaelis-Menten type equation can represent the results of the kinetic test.

Predicting pesticide concentrations in river water with a hydrologically calibrated basin-scale runoff model

Hydrological diffuse pollution models require calibration before they can be used to make accurate long-term predictions for a range of hydrological and meteorological conditions. As such, the applicability of the models to the dispersion of new pesticides is limited due to the lack of calibration data. In this study, the performance of a GIS-based basin-scale runoff model for predicting the concentrations of paddy-farming pesticides in river water was examined when calibrated using hydrological data alone, without optimization based on empirical pesticide concentration data. The prediction accuracy on a daily or hourly scale was somewhat unsatisfactory due to inevitable compromises concerning rice farming schedules. However, the month-averaged pesticide concentrations were satisfactorily accurate; more than 50% of predicted values were between half and twice the observed values, considering the deficiencies of the input data, particularly for pesticide usage, which may include up to 50% error.

Runoff characteristics of particulate pesticides in a river from paddy fields

Runoff characteristics of particulate pesticides from paddy fields have been intensively observed in the Koise River in Japan. The 8 pesticides that are applied to paddy fields were analyzed in both particulate and dissolved forms. The concentrations and the detection frequencies of particulate pesticides were lower than those of dissolved pesticides. The particulate pesticide concentrations in the river water were evaluated based on the soil sorption coefficient, particulate organic carbon concentration, and dissolved pesticide concentrations. The particulate pesticide concentrations in the river were higher than evaluated concentrations because the paddy soil contained more pesticides than did suspended solids in the river water discharged during rain events, and because the desorption rates of pesticides were slow. In observations made during rains, the particulate pesticide concentrations increased with the increases in both the discharge rate and the concentrations of suspended solids. The particulate loading was slight compared with dissolved loading, but particulate pesticides may be influenced by enclosed areas such as a lake or estuary because under such conditions particulate matter settles vertically and the pesticide decomposition rate in sediment is slow compared with that in water.

Homologous phases built by boron clusters and their vibrational properties

We have found a series of new rare earth boron-rich solids in REBC(N) (RE: Y, Ho, Er, Tm, and Lu), systems and their structures are solved from single crystal and/or powder X-ray diffraction data. Structure analysis results show that they are homologous with B(4)C and also show trigonal symmetry. As the two basic structural units, boron icosahedra and octahedra in the new phases form in layers and stack in different sequences which form different phases. With increasing number of icosahedral layers stacking between two neighboring octahedral layers, the c-axis of the unit cell is increased and the other two edges of the unit cell are only changed slightly. Three monophases of the series have been synthesized both in powders and as single crystals. The vibrational modes of the homologous phases are analyzed from the Raman spectra and compared with that of B(4)C.

A case of intraoperative acute aortic dissection caused by cannulation into an axillary artery

Severe atherosclerotic disease of the ascending aorta is one of the risk factors of dissection of the ascending aorta and cerebral embolism during cardiac operations with cardiopulmonary bypass. Aortic dissection is rare, but once it happens, the mortality rate is high. For the patient with severely atherosclerotic or strongly calcified aorta, we should avoid cannulation into the aorta or clamping of it. In this case, we experienced aortic dissection although we chose the arterial cannulations into the axillary arteries because of the strong calcification of the ascending aorta and the abdominal aorta. The dissection was caused by the cannulation into the axillary artery. Transesophageal echocardiography (TEE) showed the dissection during the operation and the ascending aorta was replaced soon. Early diagnosis and treatment saved the patient. This case showed the following points: 1) cannulation into an axillary artery is not always safe; 2) TEE is very useful to detect the complicated dissection during operation; 3) replacement of the ascending aorta alone can be one of the choices for the treatment of aortic dissection caused by cannulation into an axillary artery.

Magnetic resonance angiography of the forearm and hand in children

A two-dimensional time-of-flight magnetic resonance angiography was performed in 29 arms in 25 pediatric patients with congenital hand abnormalities, whose average age was three years and eight months. Venous structures were eliminated with presaturation technique and the remaining arterial system was evaluated. Magnetic resonance angiography demonstrated major arteries in the forearm well but not their branches. Even the biggest branch of the artery sometimes could not be detected. Magnetic resonance angiography and Allen test were consistent in determining patency of the palmar arch in 62% of the cases but the sensitivity was only 28%. Our experience showed that non-invasive, convenient, two-dimensional time-of-flight magnetic resonance angiography was useful for detecting continuity and spatial localisation of the major arteries in a child's forearm. However, it was not a complete alternative to conventional angiography and was unsatisfactory in delineating the vascular anatomy in the hand.

Functions of unconventional myosins in the yeast Saccharomyces cerevisiae

Unconventional myosins in the budding yeast play essential roles in diverse cellular functions, including endocytosis, actin organization, and polarized distribution of organelles. Several lines of evidence suggest that novel proteins, interacting with the unconventional myosins, regulate their functions. In this review, we focus on the functions of unconventional myosins from the point of view of myosin-interacting proteins.

Biofidelity of TRL Legform Impactor and Injury Tolerance of the Human Leg in Lateral Impact

In nonfatal car-pedestrian accidents, lower extremities are the most commonly injured body parts. The test device used to evaluate the car-front aggressiveness regarding the risk of these injuries is a legform impactor. Injury-related factors causing AIS 2+ injury in the human lower leg when exposed to a lateral impact representing a pedestrian accident should be identified. One of the test devices commonly used to evaluate the risk is the legform impactor developed by the Transport Research Laboratory (TRL). However, information about the biofidelity of this impactor and leg injury tolerance curves is lacking. Thus, the objectives of this research are: 1) to determine possible injury-related factor(s) causing AIS 2+ injury in the human lower leg when exposed to a lateral impact simulating a pedestrian accident; 2) to evaluate the biofidelity of the current version of the TRL legform impactor; and 3) to propose injury reference value for estimation of the leg and knee joint injury risk by means of a legform impactor. To determine factors causing leg fracture and knee joint ligament injury, injury-related factors were statistically tested in the present study. In this estimation, we analyzed knee lateral force, knee bending moment, knee shear displacement (i.e., relative displacement between the leg and thigh at the knee joint level in a lateral direction), knee bending angle, leg acceleration, and the impact force as factors that could correlate with the occurrence of the leg injuries. Regarding tibia fracture, both the impact force and leg acceleration were found to be significant factors. For ligament injury, it was found that only the shearing displacement was indeed very likely to be a significant factor. The TRL legform impactor was evaluated by comparing its responses with the published experimental results obtained using postmortem human subjects (PMHSs). The evaluation was done under two conditions: impact point 84 mm below the knee joint center (shearing tests) and impact point near the ankle area (bending tests). Two impact speeds were used: 5.56 m/s and 11.11 m/s. Impact force, shear displacement, and bending angle were applied to measure the TRL legform impactor biofidelity. In general, the impactor responses were outside the biofidelity corridors determined using PMHSs. The exception was the impact force in the bending setup at a speed of 5.56 m/s. To estimate the leg injury risk when using the TRL legform impactor, we determined transfer coefficients between the responses of this impactor and the human leg. Using these coefficients, we suggest an impact force of 6.9 kN and a shearing displacement of 7.9 mm as criteria for 50-percentile risk of the leg fracture and ligament injury with the TRL legform impactor.

Soft-tissue osteochondroma in the calcaneal pad: a case report

Soft-tissue osteochondromas of the foot are infrequently occurring lesions. A 65-year-old woman presented with soft-tissue osteochondroma in the soft tissues superficial to the plantar aspect of the calcaneus. The mass was densely ossified without cortical destruction or other alteration in the adjacent calcaneal bone on x-rays and computed tomography images. A 99m Tc bone scan showed a focal area of an increased uptake at the site of the mass below the calcaneus. Magnetic resonance imaging demonstrated high signal mass on T1-weighted images, isointense to fatty marrow, adjacent to the thickened plantar aponeurosis. The mass was completely excised. Histologically, mature lamellar bone was seen centrally, and the periphery was capped with hyaline cartilage. Since the tumor was located in the plantar aponeurosis and comprised of a single nodule of well-developed bone with well-organized endochondral ossification, the pathogenesis of this lesion might be related to metaplasia.

Effects of p53 mutations on cellular sensitivity to ionizing radiation

Mutations in the p53 tumor suppressor gene have been found in more than 50% of human tumors including those in breast, colon, lung, and oral cavity. However, the significance of p53 mutation in radiation sensitivity and its underlying mechanisms still remains unclear. In this study, we have measured the effects of p53 mutation on cell cycle delay, apoptosis, and radiation sensitivity using mouse cells transfected with different forms of p53 mutations. Wild-type p53 and p53-Null mouse embryo fibroblast cells were used as positive and negative controls, respectively. Exponentially growing cells were irradiated with 0- to 9-Gy gamma rays and then assayed for cell survival, p53 expression, cell cycle checkpoint, and apoptosis. Cell survivals determined by clonogenic assay show that p53 mutant cells are generally more sensitive to ionizing radiation than cells with wild-type p53. Western blot analysis indicates that exposure to 6-Gy gamma rays increases the p53 expression levels by two- to threefold in wild-type p53 cells. However, the p53 level remains unchanged in cells with mutant p53 during the same postirradiation period. Irradiation with 6-Gy gamma rays produces G2/M arrest in all cell lines, indicating that p53 is probably not involved in the G2/M checkpoint. However, all mutant cells fail to show any significant G1/S arrest after irradiation, suggesting that G1/S arrest may be implicated in radiation sensitivity. Finally, there is very little apoptosis (<3% by Tat-mediated dUTP nick-end labeling [TUNNEL] and morphologic assays) detected in wild-type and p53 mutant cell lines after 6-Gy gamma rays. Our results suggest that mutant forms of p53 represent a phenotype that affects the radiation sensitivity and is not dependent on the apoptotic pathway.